阅读说明：本技术 正畸锚固组件 (Orthodontic anchor assembly ) 是由 克雷格·马休·埃尔斯盖恩-史密斯 于 2019-03-11 设计创作，主要内容包括：一种将被施加到患者的一颗或多颗牙齿上的正畸模具,所述模具具有：至少一个腔体,所述至少一个腔体被配置成邻近所述患者的相应牙齿定位,其中所述至少一个腔体用于容纳可凝结材料以提供突起,所述突起将被固定到相应的一颗牙齿上；以及杆或短柄,所述杆或短柄安装在所述模具中并从所述至少一个腔体延伸,以便在凝结所述可凝结材料时被固定到所述突起。(An orthodontic mold to be applied to one or more teeth of a patient, the mold having: at least one cavity configured to be positioned adjacent a respective tooth of the patient, wherein the at least one cavity is to receive a settable material to provide a protrusion to be secured to the respective one of the teeth; and a stem or stub shaft mounted in the mould and extending from the at least one cavity so as to be secured to the projection when coagulating the settable material.)

1. An orthodontic mold to be applied to one or more teeth of a patient, the mold having:

at least one cavity configured to be positioned adjacent a respective tooth of the patient, wherein the at least one cavity is to receive a settable material to provide a protrusion to be secured to the respective one of the teeth; and

a rod or stub shank mounted in the mold and extending from the at least one cavity so as to be secured to the projection upon setting of the settable material.

2. The orthodontic mold of claim 1, wherein the mold comprises:

a first cavity; and

a second cavity, wherein each cavity is configured to be positioned adjacent a respective tooth of the patient.

3. An orthodontic mould according to claim 1 or 2, wherein the mould is formed from a resilient plastics material such that when resiliently deformed and applied, the mould is urged into engagement with the patient's teeth.

4. The orthodontic mold of claim 1, wherein the mold has an anterior wall positioned adjacent an anterior surface of the patient's tooth and a posterior wall positioned adjacent a posterior surface of the patient's tooth, wherein the anterior wall at least partially surrounds the cavity.

5. The orthodontic mold of claim 4, wherein the front wall and the rear wall are connected by an end wall.

6. An orthodontic die according to any one of the preceding claims, wherein the die includes a channel extending between the cavities, the rod or tube being mounted within the channel.

7. The orthodontic mold of claim 1, the channel having a retention undercut, the rod or tang snap-engaging within the retention undercut.

8. An orthodontic mold according to any one of claims 1 to 7, wherein the rod or tang has an end to engage with the settable material such that the rod or tang inhibits relative movement between the settable material projections.

9. The orthodontic mold of claim 8, wherein the end portions further enable the rod or tang to inhibit angular movement between the projections of condensable material about a longitudinal axis of the rod or tube.

10. An orthodontic splint formed of a rigid material to resist deformation and to be secured to a pair of adjacent teeth to extend between the teeth, the splint being elongate in a longitudinal direction so as to have a longitudinal axis and opposed ends spaced apart in the longitudinal direction, each end being attachable to a respective one of the teeth by a settable material, wherein each end includes a surface facing in a predetermined direction having a directional component parallel to the longitudinal axis so as to be engaged by the settable material on setting and thereby resist relative movement between each end and the relative movement to which each end is respectively attached.

11. The orthodontic splint of claim 10, wherein the splint is a rod or bar or tube.

12. The orthodontic splint of claim 10 or 11, wherein the predetermined direction is generally parallel to the longitudinal axis.

13. The orthodontic splint of claim 10 or 11, wherein the predetermined direction includes a component generally transverse to the axis.

14. An orthodontic splint formed of a rigid material to resist deformation and to be secured to a pair of adjacent teeth to extend between the teeth, the splint being elongate in a longitudinal direction so as to have a longitudinal axis and longitudinally spaced apart ends, each end being adapted to be attached to a respective one of the teeth by a settable material, and wherein the splint further comprises an elongate body extending longitudinally generally parallel to the longitudinal axis, and a projection extending from the body for attaching a tensioning member such as an elastic band, chain or wire to the splint so as to extend to another tooth.

15. The orthodontic splint of claim 14, wherein the protrusion is a hook so as to provide a notch between the hook and the body.

16. An orthodontic mold to be applied to one or more teeth of a patient, the mold having:

a first cavity;

a second cavity, wherein each cavity is configured to be positioned adjacent a respective tooth of the patient, wherein the cavities are for receiving a settable material to provide protrusions, each protrusion to be secured to a respective one of the teeth; and

a rod or tube mounted in the mould and extending between the cavities so as to be secured to the projections when coagulating the settable material.

Technical Field

The present invention relates to orthodontic anchors and splint anchors and, more particularly, but not exclusively, to orthodontic anchors that extend between and attach to two or more adjacent teeth.

Background

Orthodontics traditionally and generally involve the treatment of all teeth in the mouth or all teeth in one arch (upper or lower jaw). In the last decades, the trend toward cosmetic-motivated treatment of only the anterior teeth (especially the anterior teeth that are predominantly visible in smiles, usually the maxillary teeth) has been increasing.

Tooth enamel is typically removed from between teeth in the anterior segment or premolar segment to allow space. This created space is relocated and used to realign the curved or misaligned anterior teeth. Such stripped and removed enamel is precious, limited and non-renewable. However, when molars are used as anchoring units and for applying force to accelerate treatment, it is common for these molars to be tilted medially quickly rather than moved slowly forward in the usual manner. This pouring (tipping) and tilting (tilting) wastes any crevices created by the peeling of the enamel. The rapid tilting and frequent rotation of these teeth indicates anchoring failure caused by conventional devices. Often, more enamel needs to be stripped later in the treatment to provide enough space to achieve the realignment of the anterior teeth. The maximum amount of enamel is usually already used at initial set-up and no more is available. Even more teeth are available, which can negatively impact teeth and sometimes the periodontal health of teeth, as excessive stripping can result in too tight a root.

Conventional orthodontics utilize metal brackets and wires that are adhered to the surfaces of molars and premolars. These conventional orthodontic brackets (blackets) or orthodontic bands (bands) do not work well for orthodontic anchoring, in part because they do not successfully or precisely restrict the movement of wires attached thereto or the movement of molars as large diameter tubes or rods that are fixed or bonded to teeth.

Conventional braces and wires do not provide an optimal solution for high levels of anchoring (or immediate molars, or 6 months of rapid cosmetic treatment, or where the enamel is significantly flaking or other teeth need to be pulled distally using molars, or where rotation is enhanced or treatment time is reduced) at any time.

Plastic aligner trays are often even worse when anchoring is to be produced in the molars. The plastic aligner trays do not connect the molars together in a rigid manner and even with the attachments, the teeth can be easily moved, rotated and tilted medially (up to a point and depending on the attachment) within the aligner.

The anchoring splint fixture prevents the tilting of a single tooth so that when force is applied to bring the tooth into proximity, the tooth is slowly dragged through the bone in a parallel bodily manner, rather than merely allowing two separate teeth to easily tilt. For immediate anchoring devices, it is common and known to use "temporary anchoring devices" (TAD). One disadvantage of TAD is that it requires local anesthesia and surgery, including drilling holes in the bone or inserting small screws through the gums and into the bone. If the surgical technique is not optimal, the roots of the teeth may be touched and may cause loss, damage or stiffness of the teeth. The TAD may also loosen and fall out. TADs are typically placed between the roots of the teeth. Surgical techniques are skilled and highly demanding and general practitioners are reluctant to undertake these situations. Although TADs may function well as anchors, they are not commonly used by the average dentist due to the surgical aspects and risks involved.

An orthodontic molar/premolar splint attachment is disclosed in international patent application PCT/AU2016/000250 in which two adhesive pads are attached to either end of a connecting rod.

The splint fixing device fixes two adjacent molars together to increase the anchoring value of the two adjacent teeth. A disadvantage of such orthodontic splint fixtures is that they are typically applied prior to compression molding the mouth and/or prior to scanning the teeth and prior to constructing the aligner tray. These aligners or attachment trays need to be configured in such a way as to pass over and around the splint fixing device so that they can be placed just into and engaged with the molars so that the molars can be used as a base for delivering force to the anterior teeth. If the base is strong and stable, the target tooth will move more efficiently and more quickly.

A disadvantage of the above described splint fixing device is that the operator must carry a supply of brackets or splints that adhere to the teeth and then bond them separately. In the case of brackets, the operator must install a tube and then bond it to a metal, ceramic, plastic or fiber reinforced polymeric bracket.

It is known to form projections of composite resin (usually on the buccal or lingual surfaces-which are known as attachments) using a softer and more conformable "attachment" plastic tray that is applied to a patient's teeth, wherein the tray has a cavity into which is injected a flowable or putty-like material that sets and hardens to adhere to the patient's teeth. The protrusions are primarily designed to hold the aligner in place so that the aligner does not become progressively misaligned from the tooth on which it is to be used. The projections are not designed for molar anchorage to resist mesial pouring.

A disadvantage of current treatment techniques using a transparent aligner tray and simple buccal or lingual attachments is that the fit between the aligner and the attachment is not accurate enough and "sloppy" resulting in significant molar mesial movement.

Target

It is an object of the present invention to overcome or substantially ameliorate at least one of the above disadvantages.

Disclosure of Invention

Disclosed herein is an orthodontic mold to be applied to one or more teeth of a patient, the mold having at least one cavity configured to be positioned adjacent a respective tooth of the patient, wherein the at least one cavity is to receive a settable material to provide a protrusion to be secured to the respective one tooth; and a stem or stub shaft mounted in the mould and extending from the at least one cavity so as to be secured to the projection when coagulating the settable material.

Preferably, the mold comprises a first cavity and a second cavity, wherein each cavity is configured to be positioned adjacent a respective tooth of the patient.

Further disclosed herein is an orthodontic mold to be applied to a patient's teeth, the mold having a first cavity and a second cavity, each cavity configured to be positioned adjacent a respective tooth of the patient, wherein the cavities are for receiving a settable material to provide protrusions, each protrusion to be secured to a respective one of the teeth, and a rod or tube mounted in the mold and extending between the cavities so as to be secured to the protrusions upon setting a flowable substance.

Preferably, the mould is formed from a resilient plastics material such that, when resiliently deformed and applied to the patient, the mould is urged into engagement with the patient's teeth.

Preferably, the mold has an anterior wall positioned adjacent an anterior surface of the patient's teeth and a posterior wall positioned adjacent a posterior surface of the patient's teeth, wherein the anterior wall at least partially surrounds the cavity.

Preferably, the front wall and the rear wall are connected by an end wall.

Preferably, the mould comprises communication channels positioned between the cavities.

Preferably, the communication channel allows for the placement of a rod or tube therein.

In an alternative preferred form, the communication passage has a retention barb within which the stem snap engages.

Further disclosed herein is an orthodontic splint formed of a rigid material to resist deformation and to be secured to a pair of adjacent teeth to extend between the teeth, the splint being elongate in a longitudinal direction so as to have a longitudinal axis and longitudinally spaced apart opposed ends, each end being arranged to be attached to a respective one of the teeth by a coagulable substance, and wherein each end includes a surface facing a predetermined direction having a directional component parallel to the axis so as to be engaged by the substance when coagulated and thereby resist relative movement between each end and the relative movement to which each end is respectively attached.

Preferably, the clamping plate is a rod or a bar or a tube.

Preferably, the predetermined direction is substantially parallel to the axis.

In an alternative preferred form, the predetermined direction includes a component generally transverse to the axis.

Further disclosed herein is an orthodontic splint formed of a rigid material to resist deformation and to be secured to a pair of adjacent teeth to extend between the teeth, the splint being elongate in a longitudinal direction so as to have a longitudinal axis and longitudinally spaced apart ends, each end being arranged to be attached to a respective one of the teeth by a coagulable substance, and wherein the splint further comprises an elongate body extending longitudinally substantially parallel to the axis, and a projection extending from the body for attaching a tensioning member, such as an elastic band, chain or wire, to the splint so as to extend to the other tooth.

Preferably, the projection is a hook, so as to provide a recess between the hook and the body.

Drawings

Preferred forms of the invention will now be described, by way of example, with reference to the accompanying drawings; in the attached drawings

FIG. 1 is a schematic plan view of a patient's teeth and a mold applied thereto;

FIG. 2 is a schematic cross-sectional side view of the mold of FIG. 1;

FIG. 3 is a schematic front view of a pair of teeth to which an orthodontic device has been applied by the mold of FIG. 1;

fig. 4 is a schematic plan view of a number of stems that may be used in the mold of fig. 1-3.

FIGS. 5(A) to 5(D) are schematic side views of variations of the lever shown in FIG. 4;

FIG. 6 is a schematic side view of a variation of the lever shown in FIG. 4;

FIG. 7 is a schematic isometric view of a mold and a clamping bar mounted therein;

FIG. 8 is a schematic plan view of adjacent teeth with the splint bar applied thereto, with the associated mold at least partially enclosing the teeth;

FIG. 9 is a schematic view of another clamping bar;

FIG. 10 is a schematic isometric view of the splint bar of FIG. 9;

FIG. 11 is another schematic isometric view of the cleat rod of FIG. 9;

FIG. 12 is another isometric view of the splint rod of FIG. 9;

FIG. 13 is another isometric view of the cleat rod of FIG. 9;

FIG. 14 is a schematic side view of a variation of the pinch bar of FIG. 9;

FIG. 15 is a schematic isometric view of the pinch bar of FIG. 14;

FIG. 16 is a schematic isometric view of the pinch bar of FIG. 14;

FIG. 17 is a schematic side view of a variation of the pinch bar of FIG. 14;

FIG. 18 is a schematic side view of a variation of the lever shown in FIG. 4; and is

Fig. 19 is a schematic perspective view of the mold shown in fig. 18.

Detailed Description

In fig. 1 to 5, an orthodontic assembly 50 is schematically depicted. The assembly 50 is applied to adjacent teeth 51 and 52 of a patient.

The assembly 50 comprises a flexible mould (tray) 53 which is applied to the teeth 51 and 52 so as to be resiliently urged into engagement therewith. In this regard, the mold 53 is flexible, but resilient so as to be deformable, such that upon deformation, the mold 53 is urged into contact with the teeth 51 and 52.

The mold 53 includes a front wall 54 and a rear wall 55 connected by one or more end walls 56. The mold 53 provides a space in which the teeth 51 and 52 are positioned, and a pair of cavities 57.

Each of the cavities 57 is positioned between the mold 53 and a respective one of the teeth 51. In this embodiment, each of the cavities 57 is positioned between the front wall 54 and a respective one of the teeth 51. The front wall 54 at least partially surrounds the cavity 57.

A partition wall 58 extends from the front wall 54 towards the teeth 51, which partitions the cavity 57. Preferably, the dividing wall connects the front wall 54 with the rear wall 55.

Mounted in the wall 58 is a rod 59 which is relatively rigid to resist deformation. The rod 59 may be solid or tubular.

In a preferred form, the wall 58 has a passage or channel 63 into which the rod 59 is inserted for installation in the mould 53. Preferably, the channel 63 has a cross-sectional area such that the dividing wall 58 is urged into contact with the rod 59, thereby maintaining the rod 59 in a desired position relative to the die 53.

In an alternative preferred form, the dividing wall 58 is provided with a slot or channel 63 in which the rod 59 is snap-engaged to secure to the die 53 and to be held in a desired position and orientation relative thereto. By way of example, the wall 58 may have an undercut 86 to provide a snap-fit engagement.

When the mold 53 is applied to the teeth 51 and 52 with the rod 59 installed therein, the cavity 57 is formed. The cavity 57 is enclosed by the surface 62 of the patient's tooth 51. Thereafter, the dentist injects a flowable substance into the cavity 57, which coagulates and hardens, thereby providing a projection 60 that is secured to the tooth 51. Alternatively, the flowable substance may be inserted into the mold 53 prior to application to the teeth 51.

Once condensed in the cavity, the substance provides two attachment pads 64. Specifically, each tooth 51 has a corresponding projection 60 secured thereto. The rod 59 is secured to the tooth 51 as the flowable substance sets and hardens. The mold 53 may be removed and the projections 60 and posts 59 secured to the teeth 51 such that the projections 60 and posts 59 secure the teeth 51 together to provide a stable anchor to which other devices may be secured.

Preferably, the rod 59 has an irregular end that helps engage the projection 60, thereby preventing relative movement between the rod 59 and the projection 60.

As best shown in fig. 4, the rod 59 may have various end deformations 61 that help secure the rod 59 to the projection 60. The rod 59 may be a wire or may be a fiberglass rod or other suitable material.

The slot or channel 63 may not be completely formed in the shape of the straight bar 59, but rather allows sufficient clearance between the two attachment pads to accommodate any size of bar 59 and any deviations and bends or offsets that may be formed in the bar 59 or tube to accommodate molars that are severely malpositioned and/or misaligned in the bucco-lingual or occlusal-gingival directions, all with respect to their long axes-e.g., when the second molar is extracted and the third molar grows into space but is greatly tilted with respect to the first molar. By allowing greater volume in the slot or channel 63 between the two pads 64, the operator can bend and shape the bar 59, or can pre-form the ceramic splint securing bar 59 into the desired offset or angled bend, and does not have to worry about the upper attachment tray obstructing or interfering with the optimal positioning of the bar 59 so that the bar is centered in the adhesive that forms the attachment to the buccal or lingual surfaces of the molars or premolars. For example, if the operator uses a very thick and tacky rear composite resin in two attachment pads 64 on two adjacent molars and/or premolars, and then embeds the splint fixing bar 59 into this thick putty-like substance, the putty-like substance will hold the bar 59 in place against gravity and allow for convenient and easy delivery of the bar 59 and substance to the oral cavity without having to position or hold the bar 59 or tube, and without or without using any snap features within the plastic attachment mold 53 that might otherwise have been used to position and fix a standard straight splint fixing bar 59. The only task for the operator is to size the splint fixing bar 59 so that it fits between the two large composite pads 64 and ensures that it does not prevent the mould 53 from falling completely into the mouth. It is difficult to do this by preprogramming in a computer and then creating a matching physical splinting bar 59 at all the various angles and offsets that may be required between the two molars, and thus, by leaving sufficient space between the two cheek pads 64, an infinite number of shapes, thicknesses, angular bends and offset bends can be accommodated in the splinting bar 59 in the area between the two bonded molars/premolars pads 64, so that the operator can bend and deform the bar 59 infinitely flexibly, and still enjoy the advantages of ease of delivery and convenience with a plastic mold 53 prefabricated by the laboratory or orthodontic company, and they can simply inject some composite resinous substance into the plastic mold, then place it into the splinting bar 59, then add a small layer of composite resinous film thereon to adhere to the enamel, the composite is then simply inserted into the oral cavity and the material allowed or caused to cure (whether by light curing or self-curing mode).

In the embodiment of fig. 5, each of the rods, tubes or cleats 59 has a protrusion 65, preferably in the form of a "hook", to provide a recess 66 that can receive a tension member (such as a wire or resilient member) to extend to another tooth to apply a force thereto.

As shown in fig. 4, but as will be described with reference to fig. 5, each of the rods 59 has a longitudinal axis 67. Each end 61 has at least one surface 68 or 69 facing longitudinal axis 67. The surfaces 68 of each rod 69 face each other, while the surfaces 69 face in opposite directions to each other.

With respect to embodiments in which surfaces 68 and 69 are inclined at an acute angle relative to axis 67, each of surfaces 68 and 69 face a predetermined direction having a directional component parallel to axis 67 and a directional component perpendicular to axis 67.

Thus, surfaces 68 and 69 are at least partially transverse relative to longitudinal axis 67.

Surfaces 68 and 69 are engaged by the attachment pad 64 to inhibit relative movement between the post 59 and the associated tooth 51.

Referring to the embodiment of fig. 5a, the clamp bar 59 includes a central longitudinally extending body 71 extending between ends 72 that are projections extending generally transversely relative to the longitudinal axis 67. The surfaces 68 and 69 face in a predetermined direction 74. The projections 72 also provide resistance to angular movement between the projections 60 about the axis 67.

A projection (hook) 65 extends from the body 71 generally centrally between the ends 72.

The predetermined direction 74 is substantially parallel to the longitudinal axis 67.

In the embodiment of fig. 5b, surface 68 faces a predetermined direction 74, providing a directional component 75 that is generally transverse to axis 67 and a directional component 76 that is generally parallel to longitudinal axis 67.

In the embodiment of fig. 5c, the predetermined direction 74 also has components 75 and 76.

In the embodiment of fig. 5d, the predetermined direction 70 is substantially parallel to the axis 67.

In the embodiment of fig. 5b, the end 72 is enlarged relative to the body 71 and projects laterally therefrom.

In the embodiment of fig. 5c, the end 72 has a recess 77 for providing the surfaces 68 and 69, and thus the end deformation 61. The groove 77 also provides resistance to angular movement between the projections 60.

In the embodiment of fig. 5d, the end deformation 61 is provided by an annular flange 78 providing the surfaces 68 to 69.

In fig. 6, a variant of the clamping bar 59 is schematically depicted. In this embodiment, a splint 80 is provided that extends between a pair of adjacent teeth and is secured thereby as previously described. In this embodiment, the end 72 is provided with a hole 81 for containing a condensable substance. In the previous embodiment, the body 71 may be a rod or bar and may have a circular or other cross-section, while in the embodiment of FIG. 6, the body 71 is oval, square or generally rectangular, or may be relatively flat. The substance contained in the apertures 81 acts to resist relative angular movement between the projections 60 about the axis 67.

Referring to the embodiment of fig. 6, a splint 80 may be applied to two adjacent teeth 51, followed by application of a mold 53. The condensable matter is then delivered into the cavity 57.

In fig. 7, a splint 80, a mold 53 (not shown) applied to the teeth is schematically depicted in order to secure the splint 80 in place and thus provide delivery of the coagulable substance. In this embodiment, the splint 80 may be installed in the mold 53 and then applied to the teeth, or alternatively, the splint 80 may be applied first to the teeth and then the mold 53 applied.

Surfaces 68 and 69 border aperture 81.

In fig. 9 to 13, a variant of the clamping plate 80 is schematically depicted.

In this embodiment, the body 71 comprises two portions 82 and 83 inclined at an acute angle relative to each other. In addition, the ends 72 are generally flat and inclined to each other at an angle 84. It should also be appreciated that the ends 72 may be angularly offset relative to one another about the longitudinal axis 67.

In the embodiment of fig. 14, 15 and 16, body 71 includes body portions 85 and 86 that are offset such that end portion 72 is not aligned, i.e., offset in one direction during a direction transverse to longitudinal axis 67.

Ends 72 may be layered in a common generally planar plane or, alternatively, may be inclined relative to the plane about axis 85 and an axis generally perpendicular to axis 67.

In fig. 17, a variation of the embodiment of fig. 14, 15 and 16 is schematically depicted. In this embodiment, the protrusion 65 has been removed.

For orthodontics done in a conventional manner and not constrained by cosmetic or rapid treatment, the above-described embodiment acts as an improved splinting device and has the advantage of not requiring surgery and enabling the operator to proceed to fixing the molar splints in a stable position after the necessary time (typically 12 months to 18 months) has been spent to bring the molars into the desired position, and then the operator can apply force to these molars using them as a posterior anchoring unit, knowing that the amplitude of movement of the molars may be much less than without the anchoring device.

The above embodiments may be created on a 3-D computer file of a patient's tooth scan, or conversely, the space between a composite resin pad and splint fixing tube or rod may be manually "waxed" or created in a composite resin on a physical plaster (or other material) model, and a transparent plastic attachment tray may be made using conventional laboratory aspiration vacuum forming techniques, and thus may be used to create the matrix of the anchoring device with or without simultaneous use of attachments on other teeth. In this manner, the proposed invention has versatility in that it can be used with existing clear plastic aligner technology and [ ideally ] incorporated into clear plastic sticker template trays-or it can be used with conventional compression and laboratory plaster molds and "waxing" technology (without the use of actual wax, since wax melts when the thermoplastic tray is vacuum formed over wax, but typically a flowable composite material is used) and conventional laboratory manufacturing methods to produce clear plastic tray matrices for the purpose of securely gripping molars and/or premolars.

The above embodiments allow these pads to be actually formed on a 3-D model outside the mouth, with a transparent plastic outer template that is simply pushed against the teeth and then the composite resin is lightly cured or made self-curing. This is extremely advantageous in terms of speed and operator comfort and produces better quality results. Any burrs around the edges can be simply removed with a manual scaler, which is much easier than operating a high speed turbine or rotating a diamond bit at a rate of 300,000 revolutions per minute near the flexible and unpredictable gingival tissue. The gingiva in this region is usually rarely attached to the gingiva, and if the free gingival or buccal mucosa (somewhat flexible and prone to accidentally move into the working line) comes into contact with the rotating diamond drill, it often wraps around it and causes significant tissue damage. On the lingual side, there is the same problem of proximity, but the tongue is treated which may be very muscular and uncontrollable. In some patients, the tongue is so difficult to control that surgery on this side of the teeth is almost impossible without general anesthesia. The ability to form these post-composite attachments, whether buccal or lingual, with low-profile, easily accessible and prefabricated transparent plastic forms (eliminating the need for dental handpieces) is a significant advantage to any orthodontic operator.

The above-described embodiments do not require these prefabricated metal or ceramic brackets, but rather utilize massive pads of strong back composite resin or similar material to custom form attachment devices to the teeth that hold the splint fixation bar or tube to the buccal or lingual surfaces of the molars or premolars. An advantage of the above embodiments is that they can utilize existing plastic trays made for other purposes, such as for forming attachments to teeth, and can utilize the trays to form and deliver splinting bars or tubes with attachment regions to molars or premolars in a more efficient manner without the need to provide additional equipment or devices other than splinting bars or tubes. Another advantage is that the attachment pads or devices and the rods or tubes located between them also fortunately act as a conventional attachment that holds the aligner tray down on the teeth and helps deliver the force that has been programmed into the aligner.

With respect to the embodiment of fig. 5-17, the bar 59/splint 80 extends between one or more molars or between one molar and one premolar, and provides both secondary elastics to facilitate closure of the gap and rotation of the teeth and movement of the teeth, as well as secondary or tertiary elastics.

The splints 57, 80 allow the misaligned tooth to be fixed in position so as to maximise its anchoring-and therefore the rod 50/splint 80 must cope with the various angles that are present in orthodontic situations. The above embodiments should correspond to teeth that are inclined relative to each other and/or teeth that are vertically elevated relative to each other or alternatively positioned on the lingual or buccal side. The rod 59/clamp plate 80 may have a number of different ends 72 thereon to lock and engage the settable material/substance (composite resin). In a preferred embodiment, the rod 59/cleat 80 has parallel flanges 78 to resist twisting movement of the rod 59/cleat 80 relative to the enamel surface about axis 67. The bar 59/splint 80 may be located on the buccal surface of molars and premolars, or may be located on the lingual or palatine surface. The rod 59/splint 80 may be placed by hand over the teeth and glued or held in place by means of a flowable/settable substance or putty-like composite material, and the operator may then manually trim off the excess. The splint fixation bar is a hollow tube that has the advantage that orthodontic wires can be inserted therein to add additional or alternative force, or to treat teeth using wire-based methods and in place of plastic aligners. As an example, such tubes can be made strong and the teeth colored with zirconia.

Alternatively, once it is determined which angle or offset is most suitable for the existing misalignment of the molars, and once it has been determined by the computerized 3-D alignment procedure, the rod 59/splint 80 may be provided by the orthodontic company, then the right bar may be selected and provided to the dentist using the splint fixing tray 53 used to make the projections 60-these projections 60 may also be formed at the same time as the rod 59/splint 80 is placed onto the tooth, and the attachment tray 53 also creates composite projections 60 that surround and secure the ends 72 of the splints 57, 80. This has the following advantages: allowing the dentist to simply place the settable substance into the tray 53, insert the cleats 57, 80 into the tray 53 and embed it into the tray, and then place it over the teeth, so that the tray 53 determines the position of the cleats 57, 80 as the optimum design set in the computer model, and also determines the size of the projections 60 of the composite material that surround the ends 72 of the rods 59/cleats 80, and this also restricts the flow of the composite material, so that generally not as much cleaning, trimming or engraving work is required as compared to composite material pads that do not use a housing and are made by hand. Such orthodontic rods 59/splints 80 are designed to resist forward movement of the teeth and, in particular, resist tilting of the teeth caused by stripping of the enamel. This is typically due to distalization of the canine or premolar teeth and to distract or realign the incisors. The splints 57, 80 greatly increase anchoring and eliminate the need for placement of implants such as temporary anchoring devices, and save valuable enamel that might otherwise be lost due to the anterior mesial tilt of the molars. Although splints have been previously placed on molars, these splints have no hooks (such as the projections 65), nor bends, nor angled bends, nor offset bends, nor special blocks, slots or shapes at both ends (designed to resist rotation of the bar relative to the buccal or lingual surfaces of the teeth), nor are they designed to be placed and wrapped in a shell tray of a composite resin attachment block and delivered by the attachment tray while placing the attachment on other teeth.

Referring to the embodiment of fig. 18 and 19, the mold 53 provides a single cavity 57. In this embodiment, a portion of the cavity 57 of the first mold 53 is filled with a condensable substance, and the first end of the clamp plate 80 is mounted in the mold 53. Additional condensable substances are then inserted into the cavity to embed the splint 80 and the mold 53 is then applied to the single tooth 51. The second mold 53 is then filled with a settable substance and applied to the adjacent tooth 51. The second end 72 of the splint 80 attached to the first mold 53 may then be inserted into the cavity 57 of the second mold 53, thereby connecting the adjacent teeth 51.

The above embodiment also has the following advantages: rods 50/cleats 80 can be used that can be delivered prior to making the projections 60 prior to any scanning or any stamping of the teeth, the rods 59/cleats 80 can be placed by hand on the teeth and the projections 60 of composite material can be carved and shaped by hand, then stamped or scanned, and then made into trays 53.

Other advantages include enabling the dentist to straighten curved teeth, straighten molars, and in the middle of orthodontic treatment, the molars can then be considered sufficiently straight at some point, and then the rod 59/splint 80 can be worn to freeze those molars in place and provide substantial anchoring without having to sacrifice the position of the molars by splinting at the beginning of treatment. Otherwise, if the molars are very curved, the dentist can correct them first, then put on the straight bar 59/splint 80, then loosen the anterior teeth and use the bar 59/splint 80 and its anchors to strip the premolars and strip the canines and pull the canines back, creating a space in the front.

The above-described embodiment ensures that: the opposite reaction of pulling the molars medially is resisted as much as possible and dentists and orthodontists are not adversely affected by the obvious ease of demonstrating the anchoring of molars by computer programs, which results without the need for physical anchoring means.